2 total
Applicant removed from Minor Injury Guideline due to chronic pain; various assessments and treatments approved.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found the applicant suffered from chronic pain with functional impairment, warranting removal from the MIG.
The Tribunal granted the applicant's requests for chronic pain and psychological assessments, as well as chiropractic and massage treatment, finding them reasonable and necessary.
A psychological treatment plan was partially approved, while a duplicative psychotherapy plan was denied.
The Tribunal declined to order a special award under s. 10 of Regulation 664, finding the respondent reasonably relied on its assessors' opinions, but awarded interest on overdue benefits.
Applicant removed from Minor Injury Guideline due to pre-existing condition; disputed physiotherapy treatment plans approved.
The applicant was involved in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer denied two physiotherapy treatment plans, arguing the applicant's injuries fell within the $3,500 Minor Injury Guideline (MIG) limit.
The Tribunal found that the applicant had a documented pre-existing workplace injury to his neck and upper back that had not fully resolved prior to the accident.
Relying on compelling medical evidence from the treating physiotherapist and family physician, the Tribunal concluded the pre-existing condition precluded recovery within the MIG.
The Tribunal ordered the respondent to pay for both disputed physiotherapy treatment plans, finding them reasonable and necessary, along with interest on overdue payments.
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